NPI | 1164919247 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA 32578) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA 32578) |
Enumeration Date | 2018-04-15 |
Last Update Date | 2022-12-30 |